Vascular device for aneurysm treatment and providing blood flow into a perforator vessel

ABSTRACT

A vascular device includes a body having a first, collapsed configuration and a second, expanded configuration. The body includes a plurality of heat-set strands that are braided such that when the body is in the second configuration, the strands form a plurality of pores and one or more apertures between the strands. The apertures are generally disposed at a longitudinal center region of the body. When the body is in the second configuration, the pores at proximal and distal portions of the body are generally uniform in size and smaller in size than the apertures. The pores and the apertures are substantially the same size when the body is in the first configuration.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/826,147, filed Mar. 14, 2013, which claims priority benefit of U.S.Provisional Application Ser. No. 61/760,907, filed Feb. 5, 2013, theentirety of each of which is hereby incorporated herein by reference.

BACKGROUND

Lumens in a patient's body can change in size, shape, and/or patency,and such changes can present complications or affect associated bodilyfunctions. For example, the walls of the vasculature, particularlyarterial walls, may develop a pathological dilatation, commonly calledan aneurysm. Aneurysms are observed as a ballooning-out of the wall ofan artery. This is a result of the vessel wall being weakened bydisease, injury, or a congenital abnormality. Aneurysms have thin, weakwalls and have a tendency to rupture and are often caused or made worseby high blood pressure. Aneurysms can be found in different parts of thebody; the most common being abdominal aortic aneurysms (AAA) and thebrain or cerebral aneurysms. The mere presence of an aneurysm is notalways life-threatening, but an aneurysm can have serious healthconsequences such as a stroke if one should rupture in the brain.Additionally, a ruptured aneurysm can also result in death.

SUMMARY

The subject technology is illustrated, for example, according to variousaspects described below. Various examples of aspects of the subjecttechnology are described as numbered clauses (1, 2, 3, etc.) forconvenience. These are provided as examples, and do not limit thesubject technology. It is noted that any of the dependent clauses may becombined in any combination, and placed into a respective independentclause, e.g., clause 1, 18 and 27. The other clauses can be presented ina similar manner.

1. A vascular device, comprising:

-   -   a body having a first, collapsed configuration and a second,        expanded configuration, the body comprised of a plurality of        heat-set strands;    -   wherein the strands are braided such that when the body is in        the second configuration, the strands form a plurality of pores        and a plurality of apertures between the strands;    -   wherein the apertures are disposed at a longitudinal center        region of the body;    -   wherein, when the body is in the second configuration, the pores        at proximal and distal portions of the body are generally        uniform in size and smaller in size than the apertures; and    -   wherein the pores and the apertures are substantially the same        size when the body is in the first configuration.

2. The vascular device of clause 1, wherein the apertures are formed bydisplacement of adjacent strands.

3. The vascular device of clause 1, wherein the plurality of aperturescomprises two apertures.

4. The vascular device of clause 2, wherein the apertures are equallyspaced and radially arranged around a longitudinal axis of the body.

5. The vascular device of clause 2, wherein a center region of each ofthe apertures is disposed along a single radial cross section of thebody.

6. The vascular device of clause 1, wherein the plurality of aperturescomprises three apertures.

7. The vascular device of clause 6, wherein the apertures are equallyspaced and radially arranged around a longitudinal axis of the body.

8. The vascular device of clause 6, wherein a center region of each ofthe apertures is disposed along a single radial cross section of thebody.

9. The vascular device of clause 1, wherein the plurality of aperturescomprises four apertures.

10. The vascular device of clause 9, wherein the apertures are equallyspaced and radially arranged around a longitudinal axis of the body.

11. The vascular device of clause 9, wherein a center region of each ofthe apertures is disposed along a single radial cross section of thebody.

12. The vascular device of clause 1, wherein a number of strands in eachof a proximal, center, and distal radial cross sections of the body isthe same.

13. The vascular device of clause 1, wherein the body has a hoopstrength that is generally uniform along the body's longitudinal length.

14. The vascular device of clause 1, wherein an area of at least one ofthe apertures is about 0.005 square millimeters or larger.

15. The vascular device of clause 1, wherein an area of at least one ofthe pores is about 0.01 square millimeters or smaller.

16. The vascular device of clause 1, wherein the apertures are largerthan the pores.

17. The vascular device of clause 1, wherein a thickness of each strandis about 0.0010 to 0.0014 inches.

18. A method, for creating a plurality of apertures in a vasculardevice, comprising:

-   -   braiding a plurality of shape-memory strands to form the        vascular device, wherein the strands are braided to form a        plurality of pores between the strands, wherein the pores at        proximal and distal portions of the device are generally uniform        in size;    -   forming each of the apertures by displacing strands disposed at        a longitudinal center region of the device with a tapered        mandrel, wherein each aperture is larger than a pore; and    -   applying heat to the displaced strands to thereby set a shape of        the displaced strands.

19. The method of clause 18, wherein the plurality of aperturescomprises two apertures.

20. The method of clause 18, wherein the plurality of aperturescomprises three apertures.

21. The method of clause 18, wherein the plurality of aperturescomprises four apertures.

22. The method of clause 18, wherein the apertures are equally spacedand radially arranged around a longitudinal axis of the vascular device.

23. The method of clause 18, wherein a center region of each of theapertures is disposed along a single radial cross section of thevascular device.

24. The method of clause 18, wherein a number of strands in each of aproximal, center, and distal radial cross sections of the vasculardevice is the same.

25. The method of clause 18, wherein the vascular device has a hoopstrength that is generally uniform along the device's longitudinallength.

26. The method of clause 18, wherein the apertures are larger than thepores.

27. A method for providing blood flow into a perforator vessel extendingfrom a sac of an aneurysm, the method comprising:

-   -   positioning a vascular device in a vessel at an opening into the        aneurysm, wherein the device has a first, collapsed        configuration and a second, expanded configuration, the device        comprising:        -   a plurality of heat-set strands, wherein the strands are            braided such that when the device is in the second            configuration, the strands form a plurality of pores and a            plurality of apertures between the strands;        -   wherein the apertures are disposed at a longitudinal center            region of the device;        -   wherein, when the device is in the second configuration, the            pores at proximal and distal portions of the device are            generally uniform in size and smaller in size than the            apertures; and        -   wherein the pores and the apertures are substantially the            same size when the device is in the first configuration; and    -   aligning the longitudinal center region of the device with the        aneurysm to thereby provide blood flow into the perforator        through one of the apertures.

28. The method of clause 27, wherein the plurality of aperturescomprises two apertures.

29. The method of clause 27, wherein the plurality of aperturescomprises three apertures.

30. The method of clause 27, wherein the plurality of aperturescomprises four apertures.

31. The method of clause 27, wherein the apertures are equally spacedand radially arranged around a longitudinal axis of the vascular device.

32. The method of clause 27, wherein a center region of each of theapertures is disposed along a single radial cross section of thevascular device.

33. The method of clause 27, wherein a number of strands in each of aproximal, center, and distal radial cross sections of the vasculardevice are the same.

34. The method of clause 27, wherein the vascular device has a hoopstrength that is generally uniform along the device's longitudinallength.

35. The method of clause 27, wherein the apertures are larger than thepores.

It is understood that other configurations of the subject technologywill become readily apparent to those skilled in the art from thefollowing detailed description, wherein various configurations of thesubject technology are shown and described by way of illustration. Aswill be realized, the subject technology is capable of other anddifferent configurations and its several details are capable ofmodification in various other respects, all without departing from thescope of the subject technology. Accordingly, the drawings and detaileddescription are to be regarded as illustrative in nature and not asrestrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

A detailed description will be made with reference to the accompanyingdrawings:

FIG. 1A depicts a vascular device in a collapsed configuration,according to some embodiments of the subject technology.

FIG. 1B depicts a vascular device in an expanded configuration,according to some embodiments of the subject technology.

FIG. 1C depicts a detail view of an aperture, according to someembodiments of the subject technology.

[FIG. 1D depicts a cross section taken at a longitudinal center of avascular device, according to some embodiments of the subjecttechnology.

FIG. 1E depicts a cross section taken at a proximal region of a vasculardevice, according to some embodiments of the subject technology.

FIG. 1F depicts a cross section taken at a distal region of a vasculardevice, according to some embodiments of the subject technology.

FIG. 2 depicts a cross section view of a vessel and delivery of avascular device, according to some embodiments of the subjecttechnology.

FIG. 3 depicts a cross section view of a vessel and delivery of avascular device, according to some embodiments of the subjecttechnology.

FIG. 4 depicts a cross section view of a vessel and delivery of avascular device, according to some embodiments of the subjecttechnology.

FIG. 5 depicts a cross section view of a vessel and delivery of avascular device, according to some embodiments of the subjecttechnology.

FIG. 6 depicts a cross section view of a vessel and deployed vasculardevice, according to some embodiments of the subject technology.

DETAILED DESCRIPTION

Aneurysms may be located, for example, along vessel side walls. A neckof an aneurysm typically defines an opening of between about 2 to 25 mm,though other sizes and ranges are also possible. The neck connects ananatomical vessel lumen to a fundus of the aneurysm. In some instances,“vessel” may refer to blood vessels (including arteries and veins) orother suitable body organs having a lumen, such as the gastrointestinaltract (e.g., esophagus, stomach, small intestine, colon, rectum), bileducts, urinary bladder, ureter, urethra, trachea, bronchi, and the like.Blood flow within the anatomical lumen is channeled through the neck andinto the fundus. In response to the constant blood flow into the fundusof the aneurysm, the wall of the aneurysm continues to distend andpresents a significant risk of rupturing. When the blood within theaneurysm causes pressure against the wall of the aneurysm that exceedsthe wall strength, the aneurysm ruptures.

Reduction of blood flow to or within the aneurysm results in a reductionin force against the wall of the aneurysm and a corresponding reductionin the risk of rupturing. Conventionally, a reduction of the force andvolume of blood entering the aneurysm may be accomplished by anoccluding device. The conventional occluding device restricts blood flowto the aneurysm. The aneurysm, however, may have small perforatorvessels or arteries extending from the aneurysm. Because theconventional occluding device isolates the aneurysm from the blood flowin the vessel, any small perforator arteries or vessel branches (bothinlet and outlet branches) extending from the aneurysm are alsooccluded, thereby preventing blood from flowing into the perforatorvessels.

The vascular devices of the subject technology solve some or all of theforegoing problems by sufficiently restricting the blood flow into theaneurysm to prevent rupture while providing sufficient blood flow toperforator vessels or arteries extending from the aneurysm, or extendingfrom the parent vessel sidewall near the aneurysm neck (and/or from alocation on the sidewall between the proximal and distal ends of thevascular device when deployed). The vascular device includes anexpandable vascular device having one or more enlarged aperturesdisposed near the neck of the aneurysm. The vascular device isconfigured to reduce the laminar flow into the aneurysm to preventrupture, while providing sufficient blood flow to the perforator vesselthrough one or more of the enlarged apertures. Accordingly, the vasculardevice exhibits a porosity configured to reduce haemodynamic flow intothe aneurysm, but simultaneously allow perfusion to perforator vessels.

FIGS. 1A-1F depict a vascular device 100, according to some embodimentsof the subject technology. The vascular device 100 comprises a body 110having a first, collapsed configuration and a second, expandedconfiguration. The body is comprised of a plurality of heat-set strands112 that are braided such that when the body 110 is in the expandedconfiguration, the strands 112 form a plurality of pores 120 and aplurality of apertures 130 between the strands 112, as shown in FIG. 1B.When the body 110 is in the expanded configuration, the pores 120 atproximal and distal portions of the body 110 are generally uniform insize and smaller in size than the apertures 130. Referring to FIG. 1A,when the body 110 is in the collapsed configuration, the pores 120 andthe apertures 130 are substantially the same size.

The body 110 may be a self-expanding stent made of two or more round orovoid wire strands or filaments 112. In one aspect, the filaments mayall be of the same thickness. For example, the thickness of each strand112 may be about 0.0001 to 0.0020 inches. The filaments may be formed ofknown flexible and shape memory materials, such as nitinol. Thefilaments may be formed of platinum and stainless steel. The body 110may be fabricated from platinum/8% tungsten and 35N LT (cobalt nickelalloy, which is a low titanium version of MP35N alloy) alloy wires. Inother embodiments, one or more of the filaments can be formed of abiocompatible metal material or a biocompatible polymer, so long as thefilaments are flexible and have shape memory properties. The filamentsmay be braided into a resulting lattice-like structure. In at least oneembodiment, during braiding or winding of the body 110, the filamentsmay be loosely braided using a 1-over-2-under-2 system. In otherembodiments, however, other methods of braiding may be followed, withoutdeparting from the scope of the disclosure.

The ends of the body 110 may be cut to length and therefore remain freefor radial expansion and contraction. The body 110 may exhibit a highdegree of flexibility due to the materials used, the porosity of thebody 110, and the fact that the ends of the filaments are not secured toeach other.

The pores 120 at the proximal and distal portions of the body 110 aresized to reduce haemodynamic flow into an aneurysm and the apertures 130are sized to provide sufficient blood flow to any perforator vesselsextending from the aneurysm. For example, an area of at least one of thepores 120 may be about 0.01 square millimeters or less and an area of atleast one of the apertures 130 may be about 0.005 square millimeters ormore. In some aspects, the apertures 130 are larger than the pores 120.In some embodiments, the apertures 130 are configured to be about fivetimes the size of the pores 120. In some embodiments, the apertures 130are sized to be range from about two to about ten times the size of thepores 120, while in some embodiments, the apertures 130 are sized torange from about three to about seven times the size of the pores 120.

The apertures 130 may be disposed at a longitudinal center region of thebody 110 and be formed by displacement of adjacent strands, as shown inFIG. 1C. In one aspect, the vascular device 100 may have two apertures130 disposed at the longitudinal center region of the body 110. Inanother example, the vascular device 100 may have three apertures 130disposed at the longitudinal center region of the body 110. In yetanother example, the vascular device 100 may have four apertures 130disposed at the longitudinal center region of the body 110. AlthoughFIGS. 1A-D depict four apertures 130, it is understood that a number ofapertures greater than four may be suitable for many applications. Theapertures 130 may be equally spaced and radially arranged around alongitudinal axis 140 of the body. In some aspects, a center region 132of each of the apertures 130 is disposed along a single radial crosssection of the body 110, as shown in FIG. 1D.

In some aspects, because the pores 120 and the apertures 130 generallycomprise gaps, voids, or areas that are formed between adjacent strands112, the number of strands 112 in each of a proximal, center, and distalradial cross sections of the body 110 is the same. For example,referring to FIGS. 1D-1F, the number of strands 112 shown at theproximal cross section of the body 110, shown in FIG. 1E, is the same asthe number of strands 112 shown at the center cross section of the body110, shown in FIG. 1D, and the distal cross section of the body 110,shown in FIG. 1F. Because the number of strands 112 at each of theproximal, center, and distal radial cross sections of the body 110 isthe same, the body 110 has a hoop strength that is generally uniformalong the body's 110 longitudinal length.

In one aspect, the apertures 130 may be formed on the vascular device100 by first placing the vascular device 100 in the expandedconfiguration on a fixture and then inserting one or more taperedmandrels, depending on the number of apertures 130, through the body 110to displace the strands 112 and thereby form the apertures 130. Thedisplaced strands 112 are then heated to their shape memory temperatureto “set” the displaced strands in their displaced configuration.Thereafter, the one or more mandrels are removed from the body 110 andthe apertures 130 remain formed on the body 110.

When the vascular device 100 is in the collapsed configuration, thedisplaced strands 112 forming the apertures 130 are collapsed, alongwith all the strands 112 comprising the body 110, and the apertures 130and the pores 120 are substantially the same size, as shown in FIG. 1A.

In one aspect, the vascular device may be coated with an endothelialprogenitor cell coating to promote endothelium growth on an innersurface of the vascular device 100. Typically, the endothelium will growfrom the proximal and/or distal ends of the vascular device 100 andtraverse toward the longitudinal center of the vascular device 100. Thestrands 112 of the vascular device 100 serve as a substrate for thecells to attach thereto. As the inner surface of the vascular devicebecomes endothelialized, the pores 120 are occluded. Because theapertures 130 are larger than the pores 120, the endothelium growsaround the apertures 130 but does not occlude the apertures 130.Accordingly, the apertures 130 remain unobstructed and permit blood toflow therethrough to feed any perforator vessel emanating from ananeurysm fundus, or emanating from the parent vessel sidewall near theaneurysm neck (and/or from a location on the sidewall between theproximal and distal ends of the vascular device when deployed).

Radiopaque markers may be located adjacent the proximal or distalportions of the vascular device 100, and may be located at any positionalong the length of the vascular device 100 between a proximal anddistal end of the vascular device 100. The markers may be attached tothe vascular device 100 by techniques such as adhesives, heat fusion,interference fit, fasteners, intermediate members, coatings, or by othertechniques.

In some embodiments, the markers are comprised of ultrasonic markers,MRI-safe markers, or other markers. In some embodiments ultrasonicmarkers permit a physician to accurately determine the position of thevascular device 100 within a patient under ultrasonic visualization.Materials for an ultrasonic marker have an acoustical densitysufficiently different from the vascular device 100 to provide suitablevisualization via ultrasonic techniques. Exemplary materials comprisepolymers, metals such as tantalum, platinum, gold, tungsten and alloysof such metals, hollow glass spheres or microspheres, and othermaterials.

In some embodiments, MRI-safe markers permit a physician to accuratelydetermine the position of the vascular device 100 within a patient undermagnetic resonance imaging. Exemplary materials for making MRI-safemarker have a magnetic signature sufficiently different from thevascular device 100 to provide suitable visualization via MRItechniques. Exemplary materials comprise polymers, metals such astantalum, platinum, gold, tungsten and alloys of such metals,non-ferrous materials, and other materials.

A technique for treating an aneurysm and providing blood flow into aperforator vessel extending from a sac of the aneurysm will now bediscussed with reference to FIGS. 2-5. The vascular device 100 may bedelivered to a treatment site using a delivery system 200. The deliverysystem 200 may include a catheter, which may for example, be an over thewire (OTW) catheter, a rapid exchange (multiple lumen) catheter, or afixed wire catheter.

Prior to delivery, an outer sheath 210 is disposed over the vasculardevice 100 to confine the vascular device 100 in the first, collapsedconfiguration. The vascular device 100 is cooperatively movable withinthe outer sheath 210 in order to deliver the vascular device 100 to atreatment site, such as an aneurysm 310, within the vasculature 300 of apatient.

The outer sheath 210 may be configured to be introduced and advancedthrough the vasculature of the patient. The outer sheath 210 may be madefrom various thermoplastics, e.g., PTFE, FEP, HDPE, PEEK, etc., whichmay optionally be lined on the inner surface of the outer sheath 140 oran adjacent surface with a hydrophilic material such as PVP or someother plastic coating. Additionally, either surface may be coated withvarious combinations of different materials, depending upon the desiredresults.

The delivery system 200 also includes a shaft 220 and a guide wire 230.The shaft 220 has a guide wire lumen for allowing the guide wire 230 toextend therethrough. The shaft 220 may also include a reduced diameterat a distal region to provide sufficient annular space in which thevascular device 100 may be stowed.

Radiopaque markers may be provided at various locations along the lengthof the delivery system 200. For example, an enlarged distal tip 240 ofthe shaft 220 may be radiopaque. In another example, radiopaque markersmay be provided on the reduced diameter distal region of the shaft 220,beneath the distal and proximal end of the vascular device 100. In yetanother example, a radiopaque marker 250 may be disposed on the shaft220 adjacent to a longitudinal center of the vascular device 100,corresponding to the location of the apertures 130.

In one aspect, the vascular device 100 may be configured withdifferently sized apertures 130 and/or number of apertures 130. Aphysician may therefore select the appropriate vascular device 100 basedon a size of the aneurysm and/or a number of perforators extending fromthe aneurysm and the diameter of each aperture 130 and/or number ofapertures 130 per vascular device 100. For example, based on thediameter of each aperture 130 and the number of perforators extendingfrom the aneurysm sac and/or from the parent vessel 300, the vasculardevice 100 may be selected such that the apertures 130 in fluidcommunication with the sac (and/or with other relevant vessellocation(s)) are sufficiently large to provide sufficient blood flow toeach of the perforators when the vascular device 100 is in the second,expanded configuration. The blood flow permitted by the apertures 130 tothe perforators is sufficient to provide blood to downstream tissueswithout inducing ischemia.

In another example, based on the number of apertures 130 in the vasculardevice 100 and the number of perforators extending from the aneurysm sacand/or from the parent vessel 300, the vascular device 100 may beselected such that there are a sufficient number of apertures 130 influid communication with the sac (and/or with other relevant vessellocation(s)) to provide sufficient blood flow to each of the perforatorswhen the vascular device 100 is in the second, expanded configuration.In these applications, sufficient blood flow is provided for theperforators extending from the aneurysm sac and/or parent vessel 300 toavoid or limit ischemia to downstream tissue, but the blood flow withinthe aneurysm is disrupted sufficiently to permit healing of theaneurysm.

Referring to FIG. 2, the delivery system 200 is advanced percutaneouslyover the guide wire 230, in this example, to the site of the aneurysm310 having a perforator vessel 320 extending therefrom.

Referring to FIG. 3, after navigating the system 200 to the treatmentsite within the patient, the outer sheath 210 is withdrawn proximallywhile maintaining the position of the shaft 220 to thereby expose adistal portion of the shaft 220 and the vascular device 100. The outersheath 210 is withdrawn until a distal end of the outer sheath 210 isproximal of the vascular device 100. As the outer sheath 210 iswithdrawn, the vascular device 100 expands. During expansion, theapertures 130 may begin to take form due to the shape memory propertiesof the strands 112.

Referring to FIGS. 4 and 5, the delivery system 200 may be adjusted orwithdrawn proximally during deployment, until the radiopaque marker 250and hence the apertures 130 are centered along the length of the ostiumor neck of the aneurysm 310 and/or located on either side of the ostium,as appropriate. In other words, the longitudinal center region of thevascular device 100, the region having the apertures 130, is alignedwith the aneurysm 310 to thereby provide blood flow into the perforator320 through one of the apertures 130. In one aspect, the longitudinalcenter region of the vascular device 100 is centered along the length ofthe ostium so that at least one aperture 130 provides blood flow to theperforator 320 when the vascular device 110 is in the second, expandedconfiguration.

In one aspect, during deployment, the position of the vascular device100 within the vessel 300 may be further modified, if after initialpartial deployment of the vascular device 100, the vascular device ispositioned incorrectly or otherwise has to be relocated to properlycover the treatment site. For example, the outer sheath 210 may beadvanced distally, thereby encapsulating or compressing the vasculardevice 100 within the outer sheath 210 and allowing the system 200 to berepositioned. Accordingly, the vascular device 100 may be partiallydeployed, resheathed, and relocated multiple times in order to ensurethat the vascular device is properly deployed in the correct location.

In another aspect, because of the woven or braided structure of thevascular device 100, the strands of the vascular device 100 can alsomove relative to each other, further allowing the vascular device 100 toflex and thereby permit advancement or rotation of the unexpandedportion of the vascular device 100 against an expanded portion of thevascular device 100 that is deployed within the vessel 300. Accordingly,through rotation or positioning of the unexpanded portion relative tothe expanded portion of the vascular device 100, the apertures 130 ofthe vascular device 100 may be properly aligned and positioned at thetreatment site.

Referring to FIG. 6, once the entire vascular device 100 is fullyexpanded, the catheter, along with the outer sheath 210, shaft 220, andguide wire 230 may be withdrawn from the patient.

Initially, blood may flow to the perforator vessel 320 from theplurality of pores 120 and apertures 130. As the inner surface of thevascular device 100 becomes endothelialized, the pores 120 will becomeoccluded thereby preventing blood from flowing therethrough. The blood,however, will continue to flow through the apertures 130, therebyproviding sufficient blood flow to the perforator 320.

In one arrangement, the vascular device 100 may be comprised of metal,polymer, ceramic, permanent enduring materials, and may comprise eitheror both of non-bioabsorbable and bioabsorbable materials. Exemplarymaterials include, but are not limited to, NITINOL®, stainless steel,cobalt chromium alloys, Elgiloy, magnesium alloys, polylactic acid, polyglycolic acid, poly ester amide (PEA), poly ester urethane (PEU), aminoacid based bioanalogous polymers, tungsten, tantalum, platinum,polymers, bio-polymers, ceramics, bio-ceramics, or metallic glasses.Part or all of the medical device may elute over time substances such asdrugs, biologics, gene therapies, antithrombotics, coagulants,anti-inflammatory drugs, immunomodulator drugs, anti-proliferatives,migration inhibitors, extracellular matrix modulators, healingpromoters, re-endothelialization promoters, or other materials. In someembodiments, the vascular device 100 may be formed from materials havingshape memory properties. In some embodiments, the vascular device 100may be finished by processes to remove slag. In some embodiments, thevascular device 100 may be subjected to a tempering treatment attemperatures customarily applied to the material so that the impressedstructure is permanently established.

The vascular device 100 may have various lengths and diameters. Forexample, the vascular device 100 may have specific cross-sectionaldiameters, the diameters being measured when the vascular device 110 isfully free to expand, ranging from about 2 mm to about 6 mm. If thevascular device 110 has a diameter between about 3 mm and about 4 mm, itmay be used in a size 18 microcatheters (i.e., microcatheters with aninner diameter of approximately 0.21 inch). If the vascular device 100has a diameter between about 5 mm and about 6 mm, it may be used in asize 27 microcatheters (i.e., microcatheters with an inner diameter ofapproximately 0.027 inch). However, other suitable cross-sectionaldiameters may be used without deviating from the scope of the subjecttechnology. In some embodiments, the vascular device 100 may havelengths, measured proximally to distally along the longitudinal axis ofthe vascular device 100, ranging from about 15 mm to about 40 mm, thoughother ranges and sizes are also possible.

The detailed description set forth above is intended as a description ofvarious configurations of the subject technology and is not intended torepresent the only configurations in which the subject technology may bepracticed. The appended drawings are incorporated herein and constitutea part of the detailed description. The detailed description includesspecific details for the purpose of providing a thorough understandingof the subject technology. However, it will be apparent to those skilledin the art that the subject technology may be practiced without thesespecific details. In some instances, well-known structures andcomponents are shown in block diagram form in order to avoid obscuringthe concepts of the subject technology.

Skilled artisans may implement the described functionality in varyingways for each particular application. Various components and blocks maybe arranged differently (for example, arranged in a different order, orpartitioned in a different way) all without departing from the scope ofthe subject technology. It is understood that the specific order orhierarchy of steps in the processes disclosed is an illustration ofexemplary approaches. Based upon design preferences, it is understoodthat the specific order or hierarchy of steps in the processes may berearranged. Some of the steps may be performed simultaneously. Theaccompanying method claims present elements of the various steps in asample order, and are not meant to be limited to the specific order orhierarchy presented.

The previous description is provided to enable any person skilled in theart to practice the various aspects described herein. The previousdescription provides various examples of the subject technology, and thesubject technology is not limited to these examples. Variousmodifications to these aspects will be readily apparent to those skilledin the art, and the generic principles defined herein may be applied toother aspects. Thus, the claims are not intended to be limited to theaspects shown herein, but is to be accorded the full scope consistentwith the language claims, wherein reference to an element in thesingular is not intended to mean “one and only one” unless specificallyso stated, but rather “one or more.” Unless specifically statedotherwise, the term “some” refers to one or more. Pronouns in themasculine (for example, his) include the feminine and neuter gender (forexample, her and its) and vice versa. Headings and subheadings, if any,are used for convenience only and do not limit the invention.

A phrase such as an “aspect” does not imply that such aspect isessential to the subject technology or that such aspect applies to allconfigurations of the subject technology. A disclosure relating to anaspect may apply to all configurations, or one or more configurations.An aspect may provide one or more examples. A phrase such as an aspectmay refer to one or more aspects and vice versa. A phrase such as an“aspect” does not imply that such aspect is essential to the subjecttechnology or that such aspect applies to all configurations of thesubject technology. A disclosure relating to an aspect may apply to allaspects, or one or more aspects. An aspect may provide one or moreexamples. A phrase such as an “aspect” may refer to one or more aspectsand vice versa. A phrase such as a “configuration” does not imply thatsuch configuration is essential to the subject technology or that suchconfiguration applies to all configurations of the subject technology. Adisclosure relating to a configuration may apply to all configurations,or one or more configurations. A configuration may provide one or moreexamples. A phrase such as a “configuration” may refer to one or moreconfigurations and vice versa.

The word “exemplary” is used herein to mean “serving as an example orillustration.” Any aspect or design described herein as “exemplary” isnot necessarily to be construed as preferred or advantageous over otheraspects or designs.

All structural and functional equivalents to the elements of the variousaspects described throughout this disclosure that are known or latercome to be known to those of ordinary skill in the art are expresslyincorporated herein by reference and are intended to be encompassed bythe claims. Moreover, nothing disclosed herein is intended to bededicated to the public regardless of whether such disclosure isexplicitly recited in the claims. No claim element is to be construedunder the provisions of 35 U.S.C. §112, sixth paragraph, unless theelement is expressly recited using the phrase “means for” or, in thecase of a method claim, the element is recited using the phrase “stepfor.” Furthermore, to the extent that the term “include,” “have,” or thelike is used in the description or the claims, such term is intended tobe inclusive in a manner similar to the term “comprise” as “comprise” isinterpreted when employed as a transitional word in a claim.

What is claimed is:
 1. A method, comprising: positioning, at a targetlocation within a blood vessel, a vascular device having a body in afirst, collapsed configuration with the body comprising braided strandsforming pores and apertures between the strands, the pores and theapertures being substantially the same size as each other in the first,collapsed configuration; and expanding the body from the first,collapsed configuration to a second, expanded configuration with theapertures being disposed at a longitudinally central section of thebody, the pores being disposed at longitudinally proximal and distalsections of the body, and the pores being generally uniform in size andsmaller in size than the apertures in the second, expandedconfiguration; wherein a number of strands in each of the proximal,central, and distal sections of the body is the same.
 2. The method ofclaim 1, wherein central regions of the apertures are disposed along asingle radial cross section of the body.
 3. The method of claim 2,wherein the body has a hoop strength that is generally uniform along alongitudinal length of the body.
 4. The method of claim 1, wherein thebody has a hoop strength that is generally uniform along a longitudinallength of the body.
 5. The method of claim 1, wherein the expandingcomprises aligning at least one of the apertures to be adjacent to anostium of an aneurysm.
 6. The method of claim 1, wherein the expandingcomprises aligning at least one of the apertures to be adjacent to anopening of a perforator vessel.
 7. The method of claim 1, wherein theapertures comprises four apertures.
 8. The method of claim 1, wherein,in the second, expanded configuration, the apertures are equally spacedand radially arranged around a longitudinal axis of the body.
 9. Themethod of claim 1, wherein, in the second, expanded configuration, anarea of at least one of the apertures is 0.005 square millimeters orlarger; wherein, in the second, expanded configuration, an area of atleast one of the pores is 0.01 square millimeters or smaller; andwherein a thickness of each strand is 0.0010 to 0.0014 inches.
 10. Amethod, comprising: positioning, at a target location within a bloodvessel, a vascular device having a body in a first, collapsedconfiguration with the body comprising braided strands forming pores andapertures between the strands, the pores and the apertures beingsubstantially the same size as each other in the first, collapsedconfiguration; and expanding the body from the first, collapsedconfiguration to a second, expanded configuration with the aperturesbeing disposed at a longitudinally central section of the body, thepores being disposed at longitudinally proximal and distal sections ofthe body, and the pores being generally uniform in size and smaller insize than the apertures in the second, expanded configuration; whereincentral regions of the apertures are disposed along a single radialcross section of the body.
 11. The method of claim 10, wherein the bodyhas a hoop strength that is generally uniform along a longitudinallength of the body.
 12. The method of claim 10, wherein the expandingcomprises aligning at least one of the apertures to be adjacent to anostium of an aneurysm.
 13. The method of claim 10, wherein the expandingcomprises aligning at least one of the apertures to be adjacent to anopening of a perforator vessel.
 14. The method of claim 10, wherein theapertures comprises four apertures.
 15. The method of claim 10, wherein,in the second, expanded configuration, the apertures are equally spacedand radially arranged around a longitudinal axis of the body.
 16. Themethod of claim 10, wherein, in the second, expanded configuration, anarea of at least one of the apertures is 0.005 square millimeters orlarger; wherein, in the second, expanded configuration, an area of atleast one of the pores is 0.01 square millimeters or smaller; andwherein a thickness of each strand is 0.0010 to 0.0014 inches.
 17. Amethod, comprising: positioning, at a target location within a bloodvessel, a vascular device having a body in a first, collapsedconfiguration with the body comprising braided strands forming pores andapertures between the strands, the pores and the apertures beingsubstantially the same size as each other in the first, collapsedconfiguration; and expanding the body from the first, collapsedconfiguration to a second, expanded configuration with the aperturesbeing disposed at a longitudinally central section of the body, thepores being disposed at longitudinally proximal and distal sections ofthe body, and the pores being generally uniform in size and smaller insize than the apertures in the second, expanded configuration; whereinthe body has a hoop strength that is generally uniform along alongitudinal length of the body.
 18. The method of claim 17, wherein theexpanding comprises aligning at least one of the apertures to beadjacent to an ostium of an aneurysm.
 19. The method of claim 17,wherein the expanding comprises aligning at least one of the aperturesto be adjacent to an opening of a perforator vessel.
 20. The method ofclaim 17, wherein the apertures comprises four apertures.
 21. The methodof claim 17, wherein, in the second, expanded configuration, theapertures are equally spaced and radially arranged around a longitudinalaxis of the body.
 22. The method of claim 17, wherein, in the second,expanded configuration, an area of at least one of the apertures is0.005 square millimeters or larger; wherein, in the second, expandedconfiguration, an area of at least one of the pores is 0.01 squaremillimeters or smaller; and wherein a thickness of each strand is 0.0010to 0.0014 inches.